The Association between Maternal Sleep Disturbances and the Health Condition of Their Offspring: a Secondary Data Analysis and a Longitudinal Cohort Study( I )

The main purpose of this integrative research proposal tries to open up a novel yet important area of research in sleep deprivation, particularly focuses on the trans-generational effects of maternal early-life sleep deprivation on their offspring. This study, as the third subproject of an integrative research proposal, aims to verify the phenomena and potential mechanisms in humans based on the findings from animal studies of other 2 subprojects. Two study cohorts will be utilized to probe the research questions. The first cohort will be recruited from Taiwan’s Maternal and Child Health Database (MatCHeD). That is a nationwide, population-based dataset collecting all children born during 2004-2011 in Taiwan and follow up their medical service utilization under the coverage of Taiwan’s National Health Insurance. The database also contains information of mothers’ medical claims before the birth of those children from the National Health Insurance Research Database (NHIRD) (1998-2011). A case-control study design will be applied to analyze the data. Sleep deprivation will be approximately defined by the utilization of sedative/hypnotics. Mothers with sleep disturbances before pregnancy will be selected and their children will be followed up to the onset of metabolic and developmental disorders. The control mother-child cohort, matched with the study cohort for mother’s age and child’s gender, will also be retrieved from the MatCHeD in order to determine whether differences exist in the occurrence of specific metabolic and developmental disorders among children. The Cox proportion hazard model would be used in this study. The second cohort will be recruited from an established mother-child pair cohort followed up from the first trimester of pregnancy since 2011. That is an ongoing study and retains more than 500 mother-child pairs in this study cohort at this moment. Information of health condition, psychological state, and sleep quality before and after pregnancy is collected from recruited pregnant women in the first trimester. Regular follow up of mother and child continues from then on. This part of the subproject will classify those mothers into groups according to their sleep quality and sleep hours before pregnancy. Based on the result of sample size calculation, 60 mother with sleep deprivation and 60 mothers without sleep deprivation will be recruited. Sampled children will be evaluated for metabolic function, indicated by pituitary gland function and also receive assessment for neuropsychological development. To explore the possible mechanism underlying the trans-generational impact of maternal sleep deprivation before pregnancy, epigenetic change will be the target and will be investigated based on findings from animal studies in other 2 subprojects